If so, wouldn’t the veterans, the ones most clearly affected by the scandal, be trying to get out from under the VA?
But they’re not. They’re mad as hell, but their reaction has been to pressure Congress to put more money into VA and to improve its administration.
Legion thanks Congress for swift response:
LEADING VETERANS GROUPS RELEASE FUNDING BLUEPRINT TO ADDRESS VA ISSUES:
(Can’t seem to link directly to the article, but it’s on the VFW website, under “News” dated February 3, 2015.)
So take advantage of federalism and the private medial sector: Feds provide funding, states set up the implementation locally, with all doctors in private practice providing the actual services.
That way, you have 51 different systems of health care delivery (counting the VA as one). No-one government controls the entire system, and if one state system is markedly better, others will follow.
That’s the model of federalism as a laboratory: each state implements the system according to its own local needs, and is free to innovate to find better ways to deliver the service.
Plus, by keeping the medical profession private, you’re relying on the doctors to find new and innovative ways to deliver services, outside of the ER.
Single payer does not automatically mean a single government monopoly.
I would not wish to be reminded of a nearby place whose system refutes my arguments, either. This is the real handwaving being done here.
Yes, Americans are generally happy with their care, just like every other industrialized nation that spends far, far, far less per capita on their care.
We spend 50% more than any other nation, as a % of GDP, and still have millions of people who are trading off health care for other necessities.
Say that weak-ass shit to your boss, and find out how long you stay employed.
“Sure, our company is paying 50% more than our competitors for this service, but our service is clearly better. Yes, our competitors are just as satisfied with their service as we are with ours, but who cares about their system?”
We dump an additional 6-7% of our GDP into a service and get nothing more in return, and the supposed “businessmen” of our political system think it’s totally OK.
I think the main difference is that US companies employ people unnecessarily in the insuring and administration of health care, which creates profitable markets that support the livelihoods of a good portion of the population. This is not an argument to maintain the status quo, just a fact. People wanted to know where all that extra spending goes with no return. Well there’s your answer.
It’s not really all that intrusive. You just wipe out all the insurance companies, merge the services into one, the fed legislates the costs and you send them the bill. In the process, you would wipe out tens of billions of dollars in inefficient spending, on things like $100 boxes of Kleenex, to the inflated CEOs bonus at Medisure Inc.
I work in clinical trails and it really doesn’t work this way. While it’s true that single-payer governments get better deals on drugs, it’s not because they fix the price, it’s because they have monolithic purchasing power and buy in bulk. No different than you going to Costco vs. your local grocery store. Is your argument really that big pharma relies on the inefficient spending of disparate hospitals in order to fund their ventures?
That’s really too bad. As a Canadian, one of the main arguments I hear (really the only compelling one) is that those in the US with insurance are treated quickly and treated like valued customers.
I can’t speak to that, but I can say that my experience here in Canada has been positive. I tore my ACL last December. Had my consult in January and surgery in February. 1yr later and I’m almost 100%. It didn’t cost me a dime out of pocket and it was elective.
Demand is a function of cost and supply. If a good is perceived to be ‘free’ and available, demand is going to go up.
Paradoxically enough, making health care “free” may not help, especially on preventative care. Vaccines, for example, are free or subsidized in most states, but vaccination before the age where it is required to enter school is not much different when it is “free” vs. anywhere else.
Regards,
Shodan
Why? From what I can gather, their system has better quality and is more affordable than ours. The polling bears this out. The health outcomes bear this out. Why wouldn’t we want to emulate a system that’s better than ours? If it’s not better than ours, why are so many more Canadians happy with their system than Americans are with our system?
Personally, I would not recommend centralising the cost schedule and payer with the federal government. You can’t have a “one-size-fits-all” cost schedule in a country as huge and diverse as the US.
That’s why I’ve mentioned federalism in my earlier post. The strength of a federal state is that the federal government can set general policy and provide funding, but it gets implemented by the states at the local level. Let the states negotiate the local cost structure with the medical community, based on local conditions, and be the single-payer in the state.
Followed by immediate lawsuits because Utah and Texas don’t cover abortion.
And whenever one state covers something and another doesn’t, equal protection means that the rights of the patient are being violated.
Any “general policy” the federal government sets is going to be challenged because a state like North Dakota is going to have lower health care costs than Mississippi or New York. So no fair - they have better benefits!
The major problems of health care inflation are going to be there whether we have single payer or not. That’s why health care costs are increasing almost at the same rate in Europe as in the US, and why they are going to face rationing just like we are. They are starting from a lower base, but eventually, any country anywhere is going to have to ration. It is a question of who is best qualified to do that - the government, or insurance companies, or whoever else pays the bills.
Regards,
Shodan
It’s amusing that you start with this, then go on to list other polls from other countries that appear to suffer from the same problem you identify at the onset. The point is that you calling it ‘the disaster of private health insurance’ is mostly empty rhetoric.
Education - no (if it must be yes it should be through vouchers)
Military - yes
Police - yes
Courts/lawyer/subpoena - yes
Healthcare can be provided by the individual - other things cannot, or there would be significant externalities to doing so.
I actually called this out in the part you quoted - “while ignoring the possibility of supplemental payers for the sake of simplicity”.
You’ve paid an added cost for the government option - just up front with no choice not to. If there was a single payer option that let everyone opt out, that’d be more palatable. I don’t think that’s a workable alternative for many reasons.
Can I agree to have a co-pay and I pay less for my premiums (taxes)? If I have a private doctor that directs a certain treatment but the government doctor disagrees, do I get it? How long do I have to wait? Can I opt out?
True - this is why I said:
Does it refute the argument that providing health care is not the proper role of government?
Oh totally - wiping out all insurance companies isn’t intrusive at all. Legislating costs is not intrusive, so called unnecessary businesses as a whole right? Oh that’s right, you’re in Canada!
Let me know when you’re in control of R&D budgets.
I like Costco. I shop there often. Sometimes though, I don’t. Factors that influence that choice are: They are crowded, parking is a pain, they are far away, I don’t always need a large quantity, they don’t have the precise product I want, etc. I have a choice and often make that choice to buy the exact same product or similar one at a higher cost because other options provide greater utility. I’d be rather upset if I was forced to shop at Costco for everything, and I’d have to pay Costco even if I chose to shop somewhere else.
Like I said at the onset - I don’t think it’s the proper role of government to provide for everyone’s healthcare.
I live in the Bay Area also. I doubt it is policy to try to push stuff on people that they don’t need, no matter what one dingbat did.
Cite that a large number of people oppose Medicare? Because that is exactly what we’re talking about. If we went to a single payer system we’d probably just extend Medicare to everyone.
Unfortunately I think that you might be correct that a large number of people think that those not virtuous enough to be able to pay for their own healthcare should be SOL.
My claim wasn’t about Medicare specifically, but about the role of government providing health care. From here:
This is similar to what I stated initially - that providing health care for everyone is not the proper role of government, but there should exist a safety net for the elderly or indigent. It’s a little different, and of course the numbers aren’t precise, but the gist is similar - A large number of people don’t think health care is the proper role of government.
There could be safety nets which don’t involve single payer plans. After years of crap about how ACA is going to wreck the economy and lead to death panels and keep you from your doctor, I’m surprised that your number isn’t higher than 50%. And your philosophical opposition to single payer would seem to me to still hold for the elderly and the poor. Many people fear change, especially when there are a lot of people crying doom. They’d almost certainly be just as satisfied with single payer.
As for satisfaction with healthcare, that has to involve satisfaction with ones doctor, which is likely because of your choice. But remember, people are happy with their particular congresscritter despite thinking Congress as a whole stinks.
If I’m getting charged $20 to empty my bedpan, I want to know it, not have it lumped into some big bill. If I’m paying someone $20 to change my client’s bedpan I want to know it even more.
Splitting out the charges is fine with me. If a hospital is getting reimbursed for X, why should they have to include Y and Z also? I’m suspicious of big lumpy categories.
Your example is the hospital gaming the system. Since we know that hospitals quite close geographically charge very different rates for procedures, I’m sure this goes on all the time. I was wondering about patients gaming the system.
And the health insurance lobby spends millions every year to make sure they keep thinking that. So does the AMA. Back in the early 60s Saint Ronnie Reagan (back before he became a saint) warned everyone that if Medicare was enacted, it would be the end of freedom as we know it, it would enable the darkness of communism to exert its fatal grip over America, and someday Americans would be telling their children, and their children’s children, what it was once like when America was free.
Wander into your local clinic and ask for an MRI because you feel like one and see what happens.
Demand will go up. The question is whether unnecessary demand will go up. And if so, will demand for unnecessary expensive stuff go up? Doctors are gatekeepers for visits to expensive specialists, at least in many cases, so someone asking for an unnecessary procedure should get politely told no. If they aren’t, it might be the profit motive at work, not a single payer plan.
We a;ready have Medicare, and my insurance at least has a very low co-pay for office visits, so this increase in demand should be happening in much of the country already. I’m sure there are a few little old ladies who go to the doctor for conversation, but is this a big problem today? Hasn’t hit the papers if so.
I for one would like to express my gratitude to the American population for voluntarily taking a collective horse-dick ass-fucking from big pharma, allowing it enough gross profit to fund research that eventually benefits my country when the reasonably priced meds get to us so we can sell them back to you.
Well done.
WTF? The US pays over $8.5K per capita for healthcare, Canada a bit over $4.5K in US dollars. Cite. That is not out of pocket costs. That is total costs, whether it comes from the patient, his employer, or from taxes. A cut down to the Canadian level would significantly help both patients and employers, make Medicare good for much longer (as the lower than expected increase in costs is pushing out the time it runs into trouble already) and perhaps let us lower taxes also.
No, it doesn’t.